RESUMEN
BACKGROUND: Treatment of spine bone metastases with stereotactic radio-therapy (SBRT) may produce greater pain relief than palliative radiotherapy. AIM: To evaluate the analgesic response to SBRT. MATERIAL AND METHODS: A search was made in an electronic database of all patients treated by SBRT in our center. We found 20 patients that were treated with SBRT in the spine on 24 sites (lesions). Analgesic response was evaluated at 3 and 6 months after SBRT. Other factors such as age, sex, functional status, diagnosis, metastasis location, dosimetry and toxicity of the treatment were also described. RESULTS: The median follow-up was 8.1 months. Complete pain relief occurred at three months in 74% of the treated sites. At three months, 78% of the patients presented a functional status 0 (ECOG). The median dose used was 24 Gy in 2 fractions. No cases of G3 or greater toxicity were recorded. CONCLUSIONS: The analgesic response to SBRT seems to be better than that reported for palliative radiotherapy.
Asunto(s)
Manejo del Dolor/métodos , Radiocirugia/métodos , Neoplasias de la Columna Vertebral/radioterapia , Neoplasias de la Columna Vertebral/secundario , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dosis de Radiación , Radiocirugia/efectos adversos , Estudios Retrospectivos , Neoplasias de la Columna Vertebral/diagnóstico por imagen , Factores de Tiempo , Resultado del Tratamiento , Escala Visual AnalógicaRESUMEN
Background: Treatment of spine bone metastases with stereotactic radio-therapy (SBRT) may produce greater pain relief than palliative radiotherapy. Aim: To evaluate the analgesic response to SBRT. Material and Methods: A search was made in an electronic database of all patients treated by SBRT in our center. We found 20 patients that were treated with SBRT in the spine on 24 sites (lesions). Analgesic response was evaluated at 3 and 6 months after SBRT. Other factors such as age, sex, functional status, diagnosis, metastasis location, dosimetry and toxicity of the treatment were also described. Results: The median follow-up was 8.1 months. Complete pain relief occurred at three months in 74% of the treated sites. At three months, 78% of the patients presented a functional status 0 (ECOG). The median dose used was 24 Gy in 2 fractions. No cases of G3 or greater toxicity were recorded. Conclusions: The analgesic response to SBRT seems to be better than that reported for palliative radiotherapy.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Neoplasias de la Columna Vertebral/radioterapia , Neoplasias de la Columna Vertebral/secundario , Radiocirugia/métodos , Manejo del Dolor/métodos , Dosis de Radiación , Neoplasias de la Columna Vertebral/diagnóstico por imagen , Factores de Tiempo , Estudios Retrospectivos , Resultado del Tratamiento , Radiocirugia/efectos adversos , Escala Visual AnalógicaRESUMEN
El cáncer de recto es una enfermedad frecuente en la población, siendo un problema de salud importante a nivel nacional, con un probable aumento en la incidencia junto con la transición demográfica y epidemiológica de los últimos años. La cirugía ha sido históricamente el pilar fundamental en el tratamiento de esta patología, pero asociándose a una alta tasa de recurrencia, tanto locorregional como a distancia, como único tratamiento. Es por esto que se ha estudiado el agregar terapias adyuvantes a la cirugía, como lo es la radioterapia y quimioterapia. La evidencia ha demostrado que la adyuvancia con radioterapia más quimioterapia se asocia a mayor sobrevida global y menor recurrencia local y a distancia en comparación con la cirugía exclusiva. En el presente artículo se realiza una revisión de los principales estudios que evidencian la ventaja, tanto en sobrevida global como libre de enfermedad, del uso de la adyuvancia con radioterapia más quimioterapia, mencionando la última evidencia disponible sobre el tratamiento del cáncer de recto localmente avanzado y las perspectivas a futuro.
Rectal cancer is a common disease in general population, being a major health problem in our nation, with a likely increase in incidence associated to demographic and epidemiological transition in recent years. Historically, the surgery has been the mainstay in the treatment of this disease, but surgery alone is associated to a high rate of recurrence, both locoregional and distant. This is why it has been studied adding adjuvant therapies to surgery, as is radiotherapy and chemotherapy. The evidence has shown that adjuvant radiotherapy and chemotherapy is associated with increased overall survival and less local and distant recurrence compared to surgery alone. This article is a review of major studies that demonstrate the advantage of using adjuvant radiotherapy and chemotherapy in both overall and disease-free survival, mentioning the last evidence available in treatment of locally advanced rectal cancer.